Therapy for AuDHD adults
For adults navigating both autism and ADHD: late-identified, formally diagnosed, or somewhere in between. A space that fits how you're actually wired, not how the world expects you to perform.
When autism and ADHD overlap
AuDHD describes the experience of being both autistic and ADHD. The two are often discussed separately, but research now confirms they frequently co-occur, and the overlap creates a distinct internal experience that doesn't fit cleanly into either category alone.
You might experience deep need for routine alongside a craving for novelty. Hyperfocus that pulls you in for hours, paired with executive dysfunction that makes starting impossible. Sensory sensitivity that overwhelms you, and sensory seeking that helps you regulate. The contradictions are not a sign of confusion. They're a sign of two neurotypes operating at once.
"You don't have to choose which part of yourself to bring into therapy. Both can be in the room."
Many people with AuDHD spent years masking, accommodating, or trying to figure out why nothing fully fit. Therapy is a space to slow down, understand how you're actually wired, and build a life around that wiring rather than against it.
When two neurotypes operate at once
AuDHD isn't autism with ADHD added on, or ADHD with autism added on. It's a distinct experience where both sets of traits operate simultaneously, often pulling in opposite directions.
The contradictions make sense
If you've ever felt like you contradict yourself, like you need both structure and novelty, both quiet and stimulation, both connection and distance, you're not confused. You're navigating two neurotypes at once. These patterns are the signature of AuDHD.
The lived experience
AuDHD looks different in every person, but these patterns come up often. You may relate to some, all, or none, and that's fine.
Internal contradictions
Wanting structure and resisting it. Needing rest and craving stimulation. Loving deep focus and being unable to start. The push-pull between autistic and ADHD traits is exhausting, and it makes sense once you understand what's happening.
Burnout and shutdowns
Periods of total depletion that come from sustained masking, sensory overload, or pushing through systems that weren't built for you. AuDHD burnout often gets misread as depression or laziness.
Sensory mismatches
Bright lights and loud sounds drain you, but you also seek movement, intensity, or stimulation when understimulated. The same body that needs quiet can also need the radio on loud.
Rejection sensitivity (RSD)
Intense reactions to perceived criticism, distance, or being misunderstood. RSD is common in ADHD and amplified when masking has been part of your daily survival.
Late-identified or self-identified
Many AuDHD adults figure it out in their 20s, 30s, 40s, or later. Self-identification is valid here. You don't need a formal diagnosis to start understanding yourself.
Relational fatigue
Translating yourself for others, anticipating their reactions, suppressing your own needs to maintain connection. Relationships can feel like a job you never clock out of.
AuDHD self-screening quiz
10 quick reflection questions to help you notice patterns. This is not a diagnosis, just a starting point for self-understanding.
Therapy that fits how you're wired
I hold AANE-informed training in autism and ADHD, plus specialized training in ACT and DBT for neurodivergent clients. The work is collaborative, paced to your nervous system, and built around your actual functioning.
Neurodivergent-affirming
AuDHD is treated as a way of being, not a problem to be fixed. We don't pathologize the parts of you that work differently, we work with them.
Sensory and pacing aware
Sessions can be adjusted: cameras off, fidgets welcome, eye contact optional, regulation breaks built in. Your nervous system gets to be in charge of the pace.
Practical and reflective
We work on what's actually showing up in your daily life: regulation, masking fatigue, executive function, identity work, relationships. Not abstract theory.
Unmasking at your pace
Unmasking isn't a goal you have to reach. It's a process you get to choose. We move at the speed you can sustain, not what looks impressive.
RSD and emotional regulation
Working with rejection sensitivity, emotional flooding, and the dysregulation cycles that come from trying to function in systems that weren't designed for you.
Identity and self-compassion
AuDHD often comes with a long history of trying to be different than you are. Therapy can be a place to come back to yourself, without apology.
Wherever you are in the journey
AuDHD identity is not a single experience. People come to therapy at every stage of figuring this out. All paths are welcome.
AuDHD therapy in your state
Licensed and offering virtual therapy across four states. Click your state for state-specific information.
Common questions about AuDHD
If you're new to thinking about AuDHD, these are the questions that come up most often.
AuDHD is a term used to describe people who experience both autism and ADHD. It is not a separate diagnosis in the DSM-5, but research now confirms that autism and ADHD frequently co-occur, and the overlap creates a distinct internal experience.
People with AuDHD often experience contradictory traits at the same time: needing routine alongside craving novelty, being sensory sensitive while also seeking stimulation, having intense focus paired with executive dysfunction. These contradictions are the defining experience of AuDHD.
Yes. The DSM-5 (Diagnostic and Statistical Manual, 5th edition) was updated to allow individuals to be diagnosed with both autism spectrum disorder and ADHD simultaneously. Research suggests that 30% to 80% of autistic adults also meet criteria for ADHD, and the co-occurrence is more common than was previously recognized.
AuDHD often feels like internal contradictions: wanting both structure and novelty, needing rest and craving stimulation, loving deep focus but being unable to start tasks. Many AuDHD adults describe feeling pulled in opposite directions by their own nervous system.
Common experiences include compounded masking exhaustion, sensory mismatches (overwhelm and sensory seeking simultaneously), deeper-than-typical burnout, rejection sensitivity, and feeling like neither autism resources nor ADHD resources fully fit.
No. You don't need a formal diagnosis to begin therapy. Self-identified, questioning, late-discovered, or formally diagnosed clients are all welcome.
If you plan to use insurance, a billable mental health diagnosis is generally required for reimbursement. Private pay is always an option if you'd prefer to work without a diagnosis being submitted to insurance.
Autism shapes how a person processes sensory information, communicates, and engages with deep interests. ADHD shapes attention, executive function, and emotional regulation. AuDHD describes the experience of both being present together, which creates distinct patterns that don't fit either profile alone.
For example, an autistic person may have a strong need for routine. A person with ADHD may seek novelty and get bored easily. An AuDHD person often experiences both at once, which is why traditional ADHD or autism resources may not fully fit.
AuDHD burnout is a state of profound depletion that comes from sustained masking, sensory overload, and pushing through systems that weren't built for how you're wired. It often goes beyond regular tiredness, can take weeks or months to recover from, and is frequently misdiagnosed as depression.
Symptoms can include cognitive shutdown, loss of skills you previously had, sensory hypersensitivity, social withdrawal, and emotional flatness. Recovery requires reduced demands and significant rest, which is rarely accommodated by typical work or life structures.
Masking is the conscious or unconscious suppression of natural traits in order to fit in or appear neurotypical. AuDHD masking is particularly intense because it involves suppressing both autistic traits (stimming, special interests, sensory needs, communication style) and ADHD traits (energy levels, attention patterns, emotional intensity).
Years of compounded masking can lead to identity confusion, burnout, and a sense of not knowing who you are underneath. Therapy can be a space to gradually unmask at a pace that feels safe and sustainable.
Yes. Many AuDHD adults are not identified until their 20s, 30s, 40s, or later, often after years of being misdiagnosed with anxiety, depression, or other conditions. Adult diagnosis typically requires evaluation by a licensed psychologist, psychiatrist, or neuropsychologist who specializes in adult autism and ADHD.
Sagebrush Counseling does not provide formal diagnostic evaluations, but referrals to qualified assessment specialists are available. Therapy can also begin without a formal diagnosis if that fits your situation.
Ready to start the work?
The free 15-minute consultation is a no-pressure place to start. We'll see if we're a fit, and you'll get a clear sense of what working together would look like.
If You Need Immediate Support
If you are in crisis or experiencing a mental health emergency, please reach out for immediate help.
Call 911 for emergencies · Call or text 988 for the Suicide & Crisis Lifeline · Text HOME to 741741 for the Crisis Text Line
Or visit the Resources page for more support options.